HAART and CDL license

May 9, 2001

I have been on Norvir/Fortovase,Epivir and Zerit for 3 years since my diagnosis, still undetectable, with CD4s in the 250 range (12 percent). I am also on anabolic steroids (Anadrol,Androgel) in cycles, which have helped tremendously with muscle mass, energy. I would like to get a CDL license and try over the road trucking, but the side effects from the current regimen would make that unsafe - the drugs make me tired and feeling slightly intoxicated for at least an hour or two after taking them. Since I have advanced disease, effectively under control, I'm concerned about switching from meds that are working; however, are there any effective combos available which would likely keep the HIV under control, but without side effects that would compromise driving safety?

Response from Dr. Henry

Your regimen is not one that usually exhibits CNS side effects (as opposed to say Sustiva which is a good drug but may cause odd dreams and interfere with sleep). For some folks ritonavir gives them a drugged feeling (esp at higher doses like 400 mg BID which is often used with Fortovase). You might consider trying a boosted regimen with a lower dose of ritonavir and see if that helps (ie Kaletra which features 100 mg ritonavor twice a day). That should still be a strong PI based regimen for you. Agenerase 600 with ritonavir 100 or 200 mg BID could also be considered. Switching off a PI to something like nevirapine or abacavir could also be considered. KH

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